Healthcare Provider Details

I. General information

NPI: 1396663233
Provider Name (Legal Business Name): ZION CONGREGATE LIVING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

986 W MARSHALL BLVD
SAN BERNARDINO CA
92405-2805
US

IV. Provider business mailing address

986 W MARSHALL BLVD
SAN BERNARDINO CA
92405-2805
US

V. Phone/Fax

Practice location:
  • Phone: 909-525-6757
  • Fax:
Mailing address:
  • Phone: 909-525-6757
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: IMELDA JULIAN
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 909-525-6757